A Novel Algorithmic Approach to Chronic Forearm Longitudinal Instability

The Essex-Lopresti Injury

SUMMARY

The classic Essex-Lopresti injury (ELI) pattern is a radial head fracture and disruption of the central band, which compromises the longitudinal radioulnar relationship. Delayed recognition and inappropriate treatment of ELI can be devasting to a patient's function. The recent literature has demonstrated an improved understanding of the mechanism of ELI. This has facilitated early diagnosis, appropriate treatment, and compelling outcomes. Further investigation will contribute to the standardization of treatment methods and algorithms for concomitant injury.

Addressing the Central Band in Acute and Chronic Essex-Lopresti Injury: A Case Report and Technique Description

CASE

A 34-year-old man was acutely treated with radial head arthroplasty and central band repair following Essex-Lopresti injury. A 38-year-old man presented with chronic longitudinal instability following failed radial head arthroplasty, which was performed for failed fixation. Treatment with revision radial head arthroplasty and central band reconstruction restored longitudinal stability.

CONCLUSION

We have a low threshold to repair the central band in acute Essex-Lopresti injury with sufficient evidence of disruption. Nearly all chronic cases require central band reconstruction to restore longitudinal stability. We do not temporarily pin the DRUJ, and distal ulnar shortening is rarely indicated.

Defining acute Essex-Lopresti injuries is problematic and variable: a systematic review

Purpose

Methods

Results

Conclusions